Perioperative Changes in Expression of Surface Antigen HLA-DR and CD11b and Serum Cytokine IL-6 and IL-8 Levels in Patients with Cancer of the Digestive Organs

Hajime Nakase, Koji Kono, Takayoshi Sekikawa, Hidehiko Iizuka, Yoshiro Matsumoto

The First Department of Surgery, Yamanashi Medical University

We studied the immunosuppressive state of patients with cancer of the digestive organs in the perioperative period by determining expression of surface antigen HLA-DR and CD11b on monocytes and serum cytokine IL-6 and IL-8 levels. Peripheral blood samples of 48 patients who received gastrectomy for gastric cancer (n=23), esophagectomy (transthoracic and abdominal approach) for esophageal cancer (n=8), pancreatoduodenectomy for pancreatic cancer (n=7) and colectomy for colon cancer, were examined on the preoperative day and the 1st, 3rd, 5th, 7th and 14th postoperative day. The mean fluorescence intensity of surface antigen HLA-DR and CD11b expressed on monocytes was determined by flowcytometry and serum cytokines were assayed by ELISA. In patients with esophageal cancer, the expression of CD11b on monocytes was at lower levels in the postoperative course compared to that of the other groups, and the levels of serum IL-8 remained higher than those of the other groups in the perioperative course. In pancreatic cancer patients, the level of expression of CD11b was elevated on the 1st day after surgery, but on the 14th day it dropped to a level lower as well as that of patients with esophageal cancer. Major surgical stress for esophageal or pancreatic cancer induced decreased expression of CD11b on monocytes, which is thought to be related to monocyte adhesion. This phenotypic change of monocyte was suggested to be associated with hypercytokinemia caused by surgical stress.

Key words
immunosuppressive state of cancer patients, surgical stress, monocyte surface antigen, expression of CD11b on monocytes, serum IL-8 level

Reprint requests
Hajime Nakase The First Department of Surgery, Yamanashi Medical University
1110 Shimokato, Tamaho, Nakakomagun, Yamanashi, 409-3821 JAPAN

Accepted
April 22, 1998

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